Ending Medical Complicity With Skilled-Nursing Facility Discrimination Against People With Opioid Use Disorder
Authors: Shawn M. Cohen, Rebekah Joab, Kathryn M. Bolles, Sally Friedman, Simeon D. Kimmel
Journal: Annals of Internal Medicine (2023)

Ideas and OpinionsMarch 2023Ending Medical Complicity With Skilled-Nursing Facility Discrimination Against People With Opioid Use DisorderShawn M. Cohen, MD, Rebekah Joab, JD, Kathryn M. Bolles, MD, Sally Friedman, JD, and Simeon D. Kimmel, MD, MAShawn M. Cohen, MDProgram in Addiction Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut (S.M.C.), Rebekah Joab, JDLegal Action Center, New York, New York (R.J., S.F.), Kathryn M. Bolles, MDHospital Medicine Program, Division of General Internal Medicine, University of Washington, Seattle, Washington (K.M.B.), Sally Friedman, JDLegal Action Center, New York, New York (R.J., S.F.), and Simeon D. Kimmel, MD, MASections of General Internal Medicine and Infectious Diseases, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts (S.D.K.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-3049 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Rose (name has been changed for privacy) lay in bed in the surgical intensive care unit after falling down the stairs, awaiting surgery to stabilize her spine. She worried as much about where she would recover after hospitalization as about whether her surgery would be successful. Rose needed physical therapy and nursing care, often offered in skilled-nursing facilities (SNFs), but she had opioid use disorder (OUD) and received treatment with methadone. From past hospitalizations, she knew that nearby SNFs did not accept patients treated with methadone. She had been in sustained remission for more than a decade, but this did ...References1. National Academies of Sciences, Engineering, and Medicine. Medications for Opioid Use Disorder Save Lives. National Academies Pr; 2019. doi:10.17226/25310 CrossrefGoogle Scholar2. Kimmel SD, Rosenmoss S, Bearnot B, et al. Rejection of patients with opioid use disorder referred for post-acute medical care before and after an anti-discrimination settlement in Massachusetts. J Addict Med. 2021;15:20-26. [PMID: 32675798] doi:10.1097/ADM.0000000000000693 CrossrefMedlineGoogle Scholar3. Kimmel SD, Rosenmoss S, Bearnot B, et al. Northeast postacute medical facilities disproportionately reject referrals for patients with opioid use disorder. Health Aff (Millwood). 2022;41:434-444. [PMID: 35254930] doi:10.1377/hlthaff.2021.01242 CrossrefMedlineGoogle Scholar4. Waters K, Handa L, Caballero B, et al. Substance use disorder as a predictor of skilled nursing facility referral failure. 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United States Code, 2012 Edition, Supplement 4, Title 24 - Labor and Title 42 - The Public Health and Welfare. 42 U.S.C. § 12132; 42 U.S.C. § 12182; 29 U.S.C. § 794; 42 U.S.C. § 18116. Google Scholar9. Cases Involving Discrimination Based on Treatment with Medication for Opioid Use Disorder. Legal Action Center. 6 June 2022. Accessed at www.lac.org/assets/files/Cases-involving-denial-of-access-to-MOUD.pdf on 10 January 2022. Google Scholar10. The Americans with Disabilities Act and the Opioid Crisis: Combating Discrimination Against People in Treatment or Recovery. U.S. Department of Justice, Civil Rights Division. Accessed at https://archive.ada.gov/opioid_guidance.pdf on 10 January 2022. Google Scholar Author, Article, and Disclosure InformationAuthors: Shawn M. Cohen, MD; Rebekah Joab, JD; Kathryn M. Bolles, MD; Sally Friedman, JD; Simeon D. Kimmel, MD, MAAffiliations: Program in Addiction Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut (S.M.C.)Legal Action Center, New York, New York (R.J., S.F.)Hospital Medicine Program, Division of General Internal Medicine, University of Washington, Seattle, Washington (K.M.B.)Sections of General Internal Medicine and Infectious Diseases, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts (S.D.K.).Financial Support: Dr. Kimmel reports support from the National Institute of Drug Abuse (K23DA054363).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3049.Corresponding Author: Shawn M. Cohen, MD, Yale School of Medicine, 367 Cedar Street, Harkness Hall A Suite 417A, New Haven, CT 06510; e-mail, shawn.cohen@yale.edu.Author Contributions: Conception and design: S.M. Cohen. R. Joab, K.M. Bolles, S. Friedman, S.D. KimmelDrafting of the article: S.M. Cohen. R. Joab, K.M. Bolles, S. Friedman, S.D. KimmelCritical revision for important intellectual content: S.M. Cohen. R. Joab, K.M. Bolles, S. Friedman, S.D. KimmelFinal approval of the article: S.M. Cohen. R. Joab, K.M. Bolles, S. Friedman, S.D. KimmelThis article was published at Annals.org on 7 February 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics March 2023Volume 176, Issue 3Page: 410-412KeywordsHospital medicineOpioid use disorderPatient advocacyPrevention, policy, and public health ePublished: 7 February 2023 Issue Published: March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...